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Nowadays airbags are part of the standard equipment in almost all new cars. While airbags are saving an increasing number of people from severe injuries and death in moderate and high speed crashes, they do not completely prevent dashboard injuries. The most common mechanism in dashboard injuries is a posteriorly directed force to the proximal tibia with the knee flexed. This may occur during a motor vehicle frontal impact accident when a knee of the driver or the front-seat passenger strikes the dashboard. The posterior force can be combined with a abducting or rotational force leading to concomitant lateral or posterolateral injury. Car and airbag manufacturers therefore develop special inflatable systems to reduce the impact force in dashboard injuries. Every new inflatable system, however, has to be evaluated in out of position situations in which the system might cause injuries to certain body areas. Therefore, we investigated a new kneebag system in different critical seating positions of post mortem test subjects (PMTS). The tested knee airbag module is a folded airbag (18 litre volume) which is installed below the lower section of the instrument panel of a passenger car. Using four PMTS (2 male, 2 female, age 36"67) the following positions were tested: normal seating position, knee flexed >90 degrees and knee flexed <60 degrees in static deployment tests with direct contact. In addition a dynamic test (48.8kph, AAMA-pulse) was carried out with the PMTS belted in a normal seating position. The inflation phase and the impact of the system on the knee/lower leg were analysed by high speed videos. After the test the lower legs of the PMTS were examined by Xray and autopsy. All soft tissue injuries and bone fractures were recorded. All the tests could be evaluated. Except some superficial skin lesions in the impact area no fracture of the bones around the knee and no knee ligament and tendon injuries were observed. Neither video analysis nor autopsy of the PMTS showed any critical contact injuries caused by the inflation process of the bag. Therefore, it can be concluded that in the tested seating positions which are the most critical for the knee area the knee bag system is safe.
The improvement of passive car security devices led to a reduction of injuries, especially of the head, the neck and the torso mainly due to the airbag function. The passenger's foot and ankle could not profit from this development. Some investigators even reported a progression of leg injuries (1). In this study, we investigated a current collective of patients with foot and ankle fractures or severe soft tissue injuries in relation with defined crash parameters. Special interest was paid to the car's footwell.
Sedan type vehicles in which adult rear seat passengers were present and which were involved in frontal collisions were investigated, and the influence of unbelted rear seat passengers on the injuries of front seat occupants was studied. Unbelted rear seat passengers move forward during impact. It was observed that there were not only cases in which front seat occupants sustained injuries caused by direct contact with rear seat passengers, but also cases where front seat occupants received severe injuries due to additional force from rear seat passengers, either impacting directly or indirectly as a result of deformation of the front seat. Severe injuries of front seat occupants were observed in the latter cases. This research validates the importance of seat-belt use for rear seat passengers, not only to protect themselves but also to mitigate injuries of front seat occupants.
Since the compulsory use of child restraints for children up to 5 years of age was introduced in 2000, restraint use among younger children has increased significantly. However, the observed rate of child restraint use plateaus at around 50%, and apparently little spillover effect has been found for older children who are not covered by the law. This report examines the restraint use patterns for children who were injured in cars in relation to driver and child passenger characteristics. Univariate and multivariate analyses were conducted to describe the association between the outcome measure (the proper use of restraints for children) and relevant variables. Better ways for parents and caregivers to improve the use of restraints for children are also discussed.
Description of road traffic related knee injuries in published investigations is very heterogeneous. The purpose of this study was to estimate the risk of knee injuries in real world car impacts in Germany focusing vulnerable road users (pedestrians, bicyclists and motorcyclists) and restrained car drivers. The accident research unit analyses technical and medical data collected shortly after the accident at scene. Two different periods (years 1985-1993 and 1995-2003) were compared focusing on knee injuries (Abbreviated Injury Scale (AISKnee) 2/3). In order to determine the influences type of collision, direction and speed as well as the injury pattern and different injury scores (AIS, MAIS, ISS) were examined. 1.794 pedestrians, 742 motorcyclists, 2.728 bicyclists and 1.116 car drivers were extracted. 2% had serious ligamentous or bony injuries in relation to all injured. The risk of injury is higher for twowheelers than for pedestrians, but knee injury severity is higher for the latter group. Overall the current knee injury risk is low and significant reduced comparing both time periods (27%, p<0,0001). Severe injuries (AISKnee 2/3) were below 1%). Improved aerodynamic design of car fronts reduced the risk for severe knee injuries significantly (p=0,0015). Highest risk of injury is for motorcycle followed by pedestrians, respectively. Knee protectors could prevent injuries by reducing local forces. The classically described dashboard injury was rarely identified. The overall injury risk for knee injuries in road traffic is lower than estimated and reduced comparing both periods. The aerodynamic shape of current cars compared to older types reduced the incidence and severity of knee injuries. Further modification and optimization of the interior and exterior design could be a proper measurement. Classic described injury mechanisms were rarely identified. It seems that the AIS is still underestimating extremity injuries and their long term results.
The significant demographic changes are predicted for the European future. The age group over 65 years is permanently increasing and over next 30 years every fourth person will belong to this group. This development will continue so far that by 2050 in many countries will double the percentage of the population aged 65 and more. Many studies analyze the new phenomena of the ageing (graying) society during the last decade. Mobility is integrated part of the life of every citizen, even more it means for the elderly people. The adequate mobility is the precondition for their active life and for their social communication that contribute to their health and functional capacity and their autonomy and independency. The active seniors demand less public support. The mobility of the older citizens is closely linked with health and societal problems and creates an important public challenge. On the other side the participation of seniors in transport due to their limited physical and mental possibilities means for them an increased risk to be injured or killed. The main mobility spaces are roads that can be used not only as a traveler in a vehicle (driver or passenger) but also as a pedestrian or cyclist or even as a motorcyclist. The road traffic is then an opportunity and danger in the same time. The accident analyzes show specific risk features of seniors that are different compared with other age groups. First of all the older road users (65 and more) are facing to the higher risk (number of killed divided by the population size) to be killed in a road accident compared with the group of younger road users (0 - 64). More significant difference can be observed when comparing the road user groups. The fatality percentage of the older pedestrians is 2,5 times higher compared with the group 25 " 64. Similar frequency show the cyclist fatalities. On the other side the vehicle passengers in the younger group have more or less two time higher percentage compared to seniors and in the group of motorcyclists even achieved in 2008 almost five times higher compared with the older group. The share of the old road users fatalities (around 19%) didn"t practically change during the last 10 years in the European average. But comparing the gender involvement (2006) there is an interesting difference " female fatalities make 30, 2%, male fatalities 15, 3% of all fatalities in their groups. The risk of the senior users is more connected with their physical and mental limits than with their risk behavior. According to the Czech statistics (2007) the vehicle drivers over 65 years cause only 3, 6% of all accidents. The solution of the problem is to minimize the risk and to create a safe environment for the elderly people using the roads. In order to achieve this goal a deep knowledge of risk and of accident circumstances, full understanding of the behavior of the seniors and their limitations and accommodating approach of the whole society is necessary. Road risk of the ageing society has to be considered as a part of the health and social policy. These can build a creditable basis for the implementation of the measures that secure safe moving of seniors on the roads.
Der Allgemeine Deutsche Automobilclub e. V. (ADAC) und die Bundesanstalt für Straßenwesen (BASt) veranstalteten am 7. und 8. Oktober 2003 in Wiesbaden ihr 5. Symposium "Sicher fahren in Europa". Nach 1991, 1994, 1997 und 2000 trafen sich erneut über 200 Fachleute aus Wissenschaft, Politik, Verwaltung, Industrie, Wirtschaft und Verbänden aus ganz Europa und einigen außereuropäischen Ländern, trugen neue Forschungsergebnisse vor und erörterten aktuelle Ansätze zur Erhöhung der Sicherheit im Straßenverkehr. Dabei ging es in Vortrags- und Diskussionsbeiträgen vor allem darum, folgende verkehrspolitischen Herausforderungen und Entwicklungen für eine europaweite Verkehrssicherheitsarbeit zu beleuchten: - die Umsetzung des 3. Verkehrssicherheits-Aktionsprogrammes der EU-Kommission bis 2010, dessen Diskussion gerade begonnen hat, - die zusätzlichen Probleme und Herausforderungen für die Verkehrssicherheit, die ab 2004 durch den EU-Beitritt von 10 weiteren Mitgliedsländern entstehen, - das Bestreben vieler EU-Mitgliedsstaaten, ihre nationale Identität und ihre regionalen Besonderheiten auch auf dem Gebiet der Verkehrssicherheit zu bewahren, um die Akzeptanz und Effizienz von praktischen Maßnahmen zu sichern, ein Ziel, dem sich auch der "EU-Konvent zur Zukunft Europas" verschrieben hat. Diesen ebenso aktuellen wie grundsätzlichen Anforderungen entsprach das Veranstaltungsprogramm mit seinen verkehrspolitischen Eröffnungs-vorträgen und mit drei Fachsitzungen - zur Verbesserung der Fahrzeugsicherheit, - der Verbesserung der Straßensicherheit und - zur Verbesserung des Verhaltens von Verkehrsteilnehmern. Eine Podiumsdiskussion "Zur Harmonisierung von Verkehrsüberwachung und Sanktionen" schloss die Veranstaltung ab.